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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 434416728
Report Date: 09/07/2023
Date Signed: 09/07/2023 03:12:43 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/18/2023 and conducted by Evaluator Ashley Lopez
PUBLIC
COMPLAINT CONTROL NUMBER: 07-CC-20230718162606
FACILITY NAME:KASSEL, ALEXANDRIAFACILITY NUMBER:
434416728
ADMINISTRATOR:ALEXANDRIA KASSELFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(408) 427-2819
CITY:GILROYSTATE: CAZIP CODE:
95020
CAPACITY:14CENSUS: 4DATE:
09/07/2023
UNANNOUNCEDTIME BEGAN:
02:10 PM
MET WITH:Alexandria KasselTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Licensee does not provide adequate supervision of children in care.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs), Ashley Lopez and Samantha Yip, met with Licensee, Alexandria Kassel, and explained purpose of today's visit, to conduct an unannounced complaint investigation. LPA's were admitted into the home by licensee upon arrival.

LPAs conducted interview with Licensee and third party, obtained a current copy of the children's roster, and toured inside and outside the home. On 7/26/23 LPA witnessed 2 children outside the gated front yard with no adult supervision present.
-----------------------------------continued on 9099-C------------------------------------------
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Ashley Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 4
Control Number 07-CC-20230718162606
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME: KASSEL, ALEXANDRIA
FACILITY NUMBER: 434416728
VISIT DATE: 09/07/2023
NARRATIVE
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Based on the information obtained, the above allegation is found to be SUBSTANTIATED, meaning the allegation is valid because the preponderance of the evidence standard has been met.

As a result of today's visit a Type A deficiency was cited, see LIC9099-D.

LPA's informed the licensee to provide a copy of this licensing report dated 9/7/2023 that documents Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

Exit interview conducted and report was reviewed with the licensee, Alexandria Kassel.

A notice of site visit was given and must be posted for 30 days.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Ashley Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 07-CC-20230718162606
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN JOSE-DAY CARE, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: KASSEL, ALEXANDRIA
FACILITY NUMBER: 434416728
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/07/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/08/2023
Section Cited
CCR
102417(a)
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Operation of a Family Child Care Home: The licensee shall be present in the home and shall ensure that children in care are supervised at all times....
This requirement is not met as evidenced by:
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Licensee will submit a written attestation to licensing stating how she will stay in compliance with the supervision requirements. Licensee will submit by due date 9/8/23.
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Based on observation, on 7/26/23 LPAs witnessed 2 children outside the gated front yard with no adult supervision present, which poses an immediate health and safety risk for children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Joel Segura
LICENSING EVALUATOR NAME: Ashley Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/07/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 4